Systemic Lupus Erythematosus : Skin Lesions
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Skin Lesions of Systemic Lupus Erythematosus (SLE): The cutaneous manifestations are present in 80%-90% of patients with SLE. The lesions are variable and can simulate other dermatoses. One of the most recognizable signs is the 'butterfly rash' consisting of erythematous, edematous, scaly eruption on the bridge of the nose and spreading on to the cheeks. The patients have photosensitivity and erythematous or violaceous macopapular eruptions commonly develop on sun-exposed areas especially in light-skinned individuals.
Alopecia (both scarring and non-scarring) is seen in about 20% of patients. The non-scarring lesions are more common and consist of diffuse hair loss as a response to stress. The frontal hairs show fracturing.
Thrombocytopenia and immune-complex mediated vasculitis can occur which may result in purpura, ecchymoses, infarcts, ulcers, or gangrene in hands or digits. Livedo reticularis may develop in arms and thighs and periarticular sites due to relative ischemia in watershed zones.
In addition, numerous other less commonly occurring skin/mucosal lesions have been described in SLE, including: erythromelalgia (burning sensation and erythema following exposure to heat), hypo- and hyperpigmentation, urticarial lesions, periungual erythema, telangiectasias (around nails, fingertips and palms), splinter hemorrhages, and painless oral ulcers.
Alopecia (both scarring and non-scarring) is seen in about 20% of patients. The non-scarring lesions are more common and consist of diffuse hair loss as a response to stress. The frontal hairs show fracturing.
Thrombocytopenia and immune-complex mediated vasculitis can occur which may result in purpura, ecchymoses, infarcts, ulcers, or gangrene in hands or digits. Livedo reticularis may develop in arms and thighs and periarticular sites due to relative ischemia in watershed zones.
In addition, numerous other less commonly occurring skin/mucosal lesions have been described in SLE, including: erythromelalgia (burning sensation and erythema following exposure to heat), hypo- and hyperpigmentation, urticarial lesions, periungual erythema, telangiectasias (around nails, fingertips and palms), splinter hemorrhages, and painless oral ulcers.